The Friendship Circle extends a helping hand to families who have children with special needs, involving them in a full range of social and Judaic programs. While assisting families, our teenage volunteers become empowered and enriched - this friendship works both ways. Please have this form filled out by a non relative . Working with children requires an incredible amount of responsibility and the information you provide will be very helpful to us. All information you provide will be held in confidence. Name of Volunteer* First Name Last Name Name of Reference* First Name Last Name Phone Number* Area Code Phone Number What is your relationship with the volunteer?* The teen is able to carry out responsibilities with little or no supervision.* Strongly Agree Agree Don’t Know Disagree Strongly Disagree The Teen is very responsible. They are able to make commitments and always keep them.* Strongly Agree Agree Don’t Know Disagree Strongly Disagree This teen shows a lot of tolerance and patience.* Strongly Agree Agree Don’t Know Disagree Strongly Disagree This teen will be a valuable asset to the family.* Strongly Agree Agree Don’t Know Disagree Strongly Disagree The Teen exhibits a high maturity level for their age.* Strongly Agree Agree Don’t Know Disagree Strongly Disagree The Teen is extremely suitable to work with children who have special needs.* Strongly Agree Agree Don’t Know Disagree Strongly Disagree The Teen has a very outgoing personality.* Strongly Agree Agree Don’t Know Disagree Strongly Disagree Any important information we must be aware of:* Signature:* Date:* 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2023 2022 2021 2020 2019 Year Submit Print Form Should be Empty: This page uses TLS encryption to keep your data secure.